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Ivey was born in Atlanta, Georgia. Her mother, Mary Nell Ivey Santacroce (née McKoin), was a teacher, speech therapist, and actress who appeared in productions of Driving Miss Daisy and taught at Georgia State University; Mary Nell was considered by John Huston to be "one of the three or four greatest actresses in the world."[1] Her father, Hugh Daugherty Ivey, was a physicist and professor who taught at Georgia Tech and later worked at the Atomic Energy Commission.[2] Her parents later divorced. She has a younger brother, John, and a half-brother, Eric Santacroce, from her mother's remarriage to Dante Santacroce.[3]

Before making New York City her home in the late 1970s, Ivey appeared in numerous American and Canadian stage productions and served as director of DramaTech in Atlanta from 1974 to 1977, as had her mother before her from 1949 to 1966. In 1981, Ivey made her Broadway debut playing two small roles in a production of Macbeth; the following year she was cast in a major supporting role in a revival of Noël Coward's Present Laughter, for which she received the Clarence Derwent Award as Outstanding Featured Actress in a Play. She was nominated for two Tony Awards in the same season (1984) – as Best Featured Actress in a Musical for Stephen Sondheim's Sunday in the Park with George and Best Featured Actress in a Play for a revival of Heartbreak House – a feat repeated by only three other actresses, Amanda Plummer, Jan Maxwell and Kate Burton.[7]